HomeMy WebLinkAbout2012-005 S Planning- RS Jones & Associates for boundary survey $11,850,2Wiz-tx6
O1 ANG C STN Y CONTRACT CON'T'ROL SHEET
Routing Order: x Dpainent, 2 IT, 3 Risk Management, Financial Services, Attorney, 6 Manager, Clerk
This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager
d tormm* es the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for
BOCC approval must be submitted through, and complete, the routing process prior to agenda review. Contracts for legal review should
be completed through the legal review process prior to being routed for signature.
Department
Party endow Name: R.S. Job & Associates Party Vendor Contact Person: Robert S. Jones, PLS Contact Phone: (919)563 -3623
Party end r Address: 121 W. Clay Street, Suite A City Mebane State: NC Zip: 27302 Department: Pl�in�lnspections Amount:
$1 1,850 Purpose: Boundary Survey Budget Odes : 10620120630000 Vendor # 57711 I A if new vendors Vendor i a BD C
consultant? Yes �
❑ o� c�ontract Typ e: (Cheek one) New M Renewal [:1 Amendment ❑ Effective Date 01 18/2012 Approved by
Board Yes❑ o[A Agenda Date: Title of Contract: Professional Services
If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes❑ No ❑. If submitted for bid were
bids FPs received Yes❑ N ® Bid/ P number This contract as been reviewed and approved by the Department Director a to
technical content:
Department Director's Signature; �........ Date:- zlle4l�ee
IT Director
(Applicable only to h ere of ware pui-chases or resorted set - vices) This contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature:
Risk Management
Date:
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; Professlon l; ❑ Property.; ❑ DID No Insurance Required [j. Hold
Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as shown, this contract is approved
by the Disk Manager:
Kish Manager's Signature: Date:
Financial Services
This Contract is conditione,,d ypon appropriation by the Board of Commissioners YesE]No A budget amendment is necessary
before approval Yes❑ No [M. If budget amendment is necessary, Please attach to this form. This instrument has been pre-audited in the
4 manner required by the Local Government Budget and Fiscal Control Act:
Financial Services Director's Signature: Date:
County Attorne
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manager H (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Slignature Date: 3
County Manauer
This contract has been reviewed and is approved by the County Manager Ye�❑'�o ❑.
This contract has been reviewed and is to be su xnitted for BOCC consideration Yes [:]N :
?` `�
Manager's Signature: :. Date:
erl to the Board
Approved by B C on the day of Submitted for i signature on the day f , 20
Clerk's Signature: Date: z �.
4
Revised April 2010